Local One Day Trial

Bring A Friend For Free Promo

Thank you for visiting Transform Active. Please fill in this form to initiate your 3 days of consecutive training for FREE at Transform Active, the home of holistic fitness in Mullumbimby. Our 24 group classes, state-of-the-art facilities, and skilled trainers are designed to help you reconnect with your body and mind.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
* Name of member that referred you

First NameLast Name
Staffed hours
- Monday to Thursday: 7:30 AM - 5:30 PM
- Friday: 7:30 AM - 4:00 PM
- Saturday: 7:30 AM - 10:30 AM
What kind of training (strength, flexibility, mobility, functional, etc) are you interested in? What are your goals (weight loss, muscle gain, maintenance, etc)?
Are you interested in Personal Training?*

YesNo
Has your medical practitioner ever told you that you have a heart condition or have you ever suffered a stroke?*

YesNo
Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise?*

YesNo
Do you ever feel faint, dizzy or lose balance during physical activity/exercise?*

YesNo
If you have diabetes (type 1 or 2) have you had trouble controlling your blood sugar (glucose)in the last 3 months?*

YesNo
Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?*

YesNo
Do you have any other conditions that may require special consideration for you to exercise?*

YesNo
By completing this form you agree to the gym rules and will follow them during your time at our gym: Please note this special is for local residents only who were referered by a Transform Active Member. The three days must be used consecutively from the first day training.

1. No bags on the gym floor.

2. Closed in shoes must be worn at all times (even when doing lifts).

3. A towel must be used at all times. No towel, no train.

4. Equipment needs to be wiped down after use.

5. All equipment is to be put away back where it belongs.

Please ensure to collect your complimentary keytag during staff hours (see at top of page and on our website).

Be safe and have fun.
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Bring A Friend For Free Promo